The last 3 days have been quite a rollercoaster. Dr. Morgan switched my steroid meds from Dexahexamethasone to Prednisone on a taper down schedule on Tuesday. I was able to get through the day teaching at Belmont on Wed. However, when I was driving home, my heart started racing and I had shortness of breath. This continued as I tried to lay on the couch to relax. I felt like I was hyperventilating. I called Meghan to find Dr. Morgan but spoke with another doctor on call. He suggested I head to the ER at Vanderbilt to be safe. Luckily, my good friend Andy Seale was coming by to bring me dinner and he was able to rush me to the hospital. We waited in the ER for approximately 30 min and I was seen. I was crying, rocking back and forth and my blood pressure and heart rate were way up (heart rate was 188 when I was finally checked by the nurse). I felt like a junkie on withdrawl.

Meghan arrived and settled me down. I was kept in the hospital Wed night for observation. During Wed night I had several bloody stools and stomach cramps and could not sleep at all. The change in medicine had really done a number on me. The next day the doctors gave me a GI test to make sure I didn't have any internal bleeding or other issues, but it checked out fine. Thursday I received a chest xray, CT scan and a echocardiogram. I had done all of these at MD but the doctors at Vandi wanted to see if anything had changed. I was finally prescribed Nexium, which helped control my stomach bleeding.

Friday was chemo day and my third day at the hospital. I received a permanent IV line up my right arm to give easy access for all future treatments. After that I waited in my hospital room until 4pm. At that point the nurse started chemo, which ultimately ended up lasting until midnight. The only drug that really effected or scared me was the Rituxan which made my heart race and made my blood pressure rise. Meghan slept on the chair next to my bed and helped calm me down. I swear, you have to have a strong heart to endure all of this!
Today I woke up feeling completely exhausted--like one might feel the day after running a marathon. I couldn't move, eat or get out of bed. I did get a little sleep, but that's hard to do when the nurses come in every 30 min during the night to check your vitals. I just had a Smoothie King and I am now at home, typing on my laptop and trying to enjoy and relax with my family as they leave tomorrow.

Dave

Just got back from my first Drs appointment at Vanderbilt today. My doctor is really cool there. His name is David Morgan and he is very laid back. His teaching fellow is really great and personable too.

He loves musicians and tries to play the cello... admittedly not that good. He says that everything from MD looks great and wants to start me on my first RCHOP chemo treatment this Friday. I won't be getting a shunt as of now, so they will just administer the drugs through 6 IVs as I sit there and surf the web, watch DVDs, etc for 6 hours. I am so thankful for my colleagues at Belmont who have generously agreed to cover my Friday classes. I owe you guys one!

My doc also told me I have been going through steroid psychosis the last couple of days. I described to him that I have been really worn down as I haven't slept but 3 hours each night for the past 5 nights. I have literally been running around wired, like I am on speed. I even have been having some hallucinations*!#. He asked me if I had thought of buying expensive things and I told him went into the guitar store and was pretty close to buying a $2800 Sadowksy 5-string bass this morning.

He said I definitely need to tone down the steroid dosage. So hopefully I can sleep and think more clearly sometime soon with a new taper down dosage.

The bright spot of the day with all this cancer cloudiness? I opened my mail tonight and received a sizable royalty check for licensing two songs from my last CD to a commercial and a training video for a company out of Portland. I guess God is giving me a little encouragement to climb this mountain!

-Dave

After two trips down to MD Anderson Cancer Center in Houston I finally received an official diagnosis from my doctor. My disease has been classified as Non-Hodgkins Lymphoma, Stage 2A Diffuse Large B Cell, mediastinal mass with intermediate to advanced growth (w age adjusted IPI). The doctor was very young, but very knowledgeable. You can tell they have the best cancer care and research team down here at MD. I would recommend them to anyone in this situation.

The doctor mentioned many other medical facts (for those who love biology). She actually thought I was a biology prof until I told her I taught music. Oh, well, I seemed to still understand her… My white blood cell count is up, perhaps due to internal compression of my heart from mass. The chemo treatment should cause this to go down. My white blood cell count has gone up since last week 16.5 H to 14.1. However, the mass has shrunk from 7x8 cm to 6x6 cm (about the size of a baseball) just from taking the steroid Dexamethasone 4x daily (which Meghan will tell you sometimes makes me grumpy and very sleepless). Lets see, what else?
From the blood tests, my LDH (Lactate Dehydrogenase) is normal. My liver had unusual shape on CT, but this could just be my strange anatomy (or maybe my past heavy drinking problem – jk ;) My PET scan however, shows liver is clean with no liver lesions. SUV 34.9. My tumor is conglomeration of lymph nodes, one smaller additional effected lymph node in chest was found as well, that’s why it is stage 2 as the cancer hasn’t metastized in any other part of my body besides my upper chest cavity. The hospital lab couldn’t get MUM 1 or Key 67 counts from original biopsy so another question was whether to do another. I think in most doctors’ minds it is better to just start treatment.

So in general, the tumor seems very localized and very curable. In a way, I am actually excited to start treatment. It is like climbing a tall mountain. You know you’re going to have to climb it and it is going to be an adventure, so lets get started! I have my initial appointment with Dr. David Morgan at the Vanderbilt Cancer center next Tuesday afternoon (that’s right after the sperm bank, gotta save those guys in case the chemo kills them!).

The chemo protocol prescribed by MD will be 6 rounds every 3 weeks (RCHOP protocol) followed by 4-5 weeks of radiation. That’s another reason I want to get started ASAP. The chemo shouldn’t be that bad the first couple of cycles (except most people lose their hair on the 2nd one). Starting now would allow me to teach normally through the end of the spring semester. The only problem I may encounter is at the very end of the summer when my radiation treatments begin, but that should only be for a short while.I’m still not sure what I’ll be doing this summer. Mainly resting, exercising and eating well. I may pick up one class at TSU, practice some bass, do some dissertation writing, some songwriting and studio work. I want to spend more time with friends and Meghan. All of these activities would allow me to stay indoors and re-couperate.

As far as the treatment goes, my doctor at MD informs me that Rituxan w/CHOP (RCHOP) has been used since 1998. Before then, studies showed approx 50% chance of remission of the cancer regular CHOP treated. Today, with the Rituxan drug, the cancers of this type have an approx 90% cure rate and an 80-90% chance of disease free survival after the treatment regime with RCHOP (6 courses, every 3 weeks) followed by radiation (4-5 weeks).
My doctor tells me the main key in both the chemo and radiation treatments is to make sure the radiation provider is the upmost expert (equipment and staff) in order to prevent long-term damage to my lungs/heart around the mass.

After 2-3 courses of chemo they will do another PET/CT at MD Anderson or Vandi for more staging to see where I am. If the PET can clears after 2-3 rounds of chemo, that is a very favorable sign. After the entire treatment there is still a PET/CT given every 3mos for about 3 years. After that, things are progressive eased down and checkups are given less frequently.
"Cancer" is such a generic term. I have found it scares a lot of people when you say the word. I guess fifty years ago it was a death sentence and that attitude is still carried over by most of us. You also look at the statistics from places like the American Cancer Society and they look bleak, but only because they take in all ages, disease stages, etc. Some friends thought I was going to die last week…but then again, any of us could die at any time just by getting in a car accident, fire, etc (sorry to be morbid).

I think of all the other trials and tribulations other people have gone through, such as my Grandfather getting shot at and gassed by Germans in WWII, or my dad’s friends having to go sleepless night after night in the Jungles of Vietnam, or someone getting paralyzed from a car crash, or Jesus dying on the cross. Those are the real people we should embrace.

My battle is moderate, simply a small bump put in my way by God to teach me a few things that I need to change in my life. The nurse at MD argued that God didn’t allow this to happen, but I believe God allows everything to happen, he is in control. Meghan cited the story of Job where God allowed Satan to kill his family, take his land, property etc. but didn’t allow him to touch his person. Even after his friends tried to convince Job to hate the Lord, he refused. Job’s bounty returned ten fold in the end. I guess my point is, you don’t know what God has in store, so have faith, perservere, and enjoy every day on this earth!

I hope that fills everyone a little for now. I will blog more when my treatment starts and let everyone know how it is going.

-Dave

I just wanted to update everyone on Dave's status. He went to the Nashville Oncologist, Dr. Patton, and got his results back from the biopsy this afternoon. Dave has non hodgkins lymphoma cancer. This type of cancer is very common in males Dave's age (15-34) and is very curable. The doctor says he is in the intermediate stages of the disease. His family and him were able to get an appointment with a great caner hospital MD Anderson and have left today and have an appointment for this Thursday at 6:30am. They plan on being there for a few days while the doctors run tests to see if the cancer has spread anywhere else. According to Dave's blood work everything looks like it is just in the one place, but the doctors will want to make sure that it isn't anywhere else. After that the doctors will decide what the best course of treatment is for Dave. Then Dave will be able to come back to Nashville and get his treatment here.

Once again, please email Dave at dave@davetough.com if you want to send immediate wishes or call me on my cell at (615) 308-3877. We are going to be setting up an update page on his website to give more immediate information as we receive it through this whole process so bookmark it for later reference and updates.

Dave wanted to let all his friends in Los Angeles know that he unfortunately will not be making the MEIEA Conference this upcoming weekend (and subsequent party) but plans to be back in full force next year.

Please continue to lift him up in prayer as he and his parents travel to Texas, for the tests that will be ran on him, wisdom for the doctors and the course of treatment that he will need. You will never know how much your prayers have meant to us. From the bottom of my heart thank you.

Meghan

John 14:12-14 Verily, verily, I say unto you, He that believes on me, the works that I do shall he do also; and greater works than these shall he do; because I go unto my Father. And whatsoever you shall ask in my name, that will I do, that the Father may be glorified in the Son. If you shall ask anything in my name, I will do it.

Hello Everyone-

I wanted to e-mail all of you to ask for your prayers for Dave Tough (my boyfriend). I know I have spoken with some of you but wanted to keep everyone updated on the latest with his situation. On Thursday he went to the ER because he had been having some swelling pain in his arm and neck, he has had this pain for the last 2-3 weeks. Thankfully, they were wise enough to take some x-rays and did a CT scan and found a 7 x 8 cm mass on the exterior of his lung. He then got a biospy to see if the tumor is cancerous. We stayed the night at Southern Medical Center just to make sure that there were no complications with the biospy procedure. We don't find out the results until Tuesday afternoon, but the preliminary results do show that he has abnormal cells. Dave is holding up pretty well. The medication they gave him has a lot of side effects, so he is experiencing some of those symptoms and sometimes can't speak. We ask that you email him at dave@davetough.com. We/he may not respond back, but we will keep you updated. We just ask that you keep us in your thoughts and prayers. Thanks, I am so thankful to have each of you in my life.

Meghan